NPIMap

Organization Active NPI

New Boston Medical Group LLP

  • Clinic/Center
  • Bella Vista, AR
National Provider Identifier
1720706922
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NEW BOSTON MEDICAL GROUP LLP
Doing business as
Bella Vista Family Clinic
Practice address
1801 Forest Hills Blvd Ste 131B
Bella Vista, AR 72715-3086
Phone
(479) 445-7906
NPI assigned
Aug 15, 2022
Organization subpart
Yes
Parent organization
NEW BOSTON MEDICAL GROUP, LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Donald Stratton DouglasNPI 1851385793
Title
Owner
Phone
(903) 278-9054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

1801 Forest Hills Blvd Ste 131B
Bella Vista, AR 72715-3086

Mailing address

1801 Forest Hills Blvd Ste 131B
Bella Vista, AR 72715-3086

Other names 1

  • Bella Vista Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221216001688 AR Part B Supplier - Clinic/Group Practice 0446230635 Receives reassigned benefits from 1 practitioner
Practice locations: Bella Vista, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Bella Vista Family Clinic

Locations

1801 Forest Hills Blvd
Ste 131B
Bella Vista, AR 72715
Phone (479) 445-7906

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1720706922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD STE 131B",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD STE 131B",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153086",
            "telephone_number": "479-445-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BOSTON MEDICAL GROUP LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW BOSTON MEDICAL GROUP, LLP",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "STRATTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-278-9054",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Vista Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.